Bariatric Times - June 2008 - (Page 13)

Bariatric Times • June 2008 Practice Management Perspective ponent for an overweight patient. A detailed history can identify potential barriers to weight loss, such as negative attitudes of family and friends, lack of opportunities for physical activity in the neighborhood, or job stress. Finally, studies show that 89 percent of patients going into weight loss surgery clinics have internet access, and 85 percent use the internet to search for relevant bariatric information.34 However, not all online information is accurate, and nurses are in a good position to encourage patients to discuss what they find online and provide them with sound, medicallybased sites. In the multidisciplinary team, the nurse is the key patient contact and the nexus for communication between team members. He or she is in a unique position to educate patients, make them feel comfortable 13 ing hypercholesterolemia, hypertension, and diabetes.16, 27 Behavioral therapists can use this information to help patients realize the benefits they stand to gain with small, modest weight loss, guiding them toward the much more achievable weight goal of 5 to 10% of their starting body weight. In encouraging individuals to integrate diet and physical activity into their lives, no change is too small— indeed, one change can become the catalyst to successful maintenance of a total lifestyle modification. Small steps, feasible goals, and recognition of their own mental barriers to change are the means by which change occurs. and accepted, and gain access to the kind of information that will help direct optimal treatment strategies. CONCLUSION It takes a multidisciplinary effort to help patients meet and overcome the challenges of lifestyle change needed to succeed at weight loss; all of the skills brought to bear by the physician, the dietitian, the exercise specialist, the psychologist, and the THE NURSE: KEEPING THE PATIENT INVOLVED In any clinical care setting, the nurse is an important figure in the patient’s experience. In a multidisciplinary weight loss effort, this role becomes even more critical. As one of the initial contacts, the nurse sets the stage for first impressions.28 Negative attitudes or stigma toward overweight or obesity can make patients uncomfortable and hinder treatment.29, 30 By the same token, nurses are in a unique position to enhance patient comfort and encourage ongoing involvement with weight loss efforts. Enhancing patient comfort begins with small, simple modifications. Waiting rooms are often poorly equipped to serve obese subjects. This can lead to embarrassment even before the medical consultation begins. By adding larger chairs, benches, and loveseats, patient size can be readily accommodated. As the visit progresses, private weighing and larger gown sizes and medical equipment, such as blood pressure cuffs, can make a very real and positive impression on an overweight patient. Once the consultation begins, it is important to invest time in the patient and take a detailed history. Many medical conditions common to obesity are treated with medications that can prevent weight loss or even promote weight gain. These include antidepressants,31 thiazolidinediones,32 and ACE inhibitors.33 Additionally, the often overlooked social environment is an important treatment com- http://www.carecredit.com

Table of Contents Feed for the Digital Edition of Bariatric Times - June 2008

Bariatric Times - June 2008 Endoluminal Treatment Options for Morbid Obesity: Devices and Techniques for Natural Orifice Approaches The Multidisciplinary Approach to Weight Loss: Defining the Roles of the Necessary Providers Acute Bleeding after Gastric Bypass Editorial Message Contents ASMBS: 25 Years Editorial Board Surgical Site Infection In The Morbidly Obese Patient: A Review Consultant's Corner The Link Between Sleep Loss and Obesity: Understanding the Mechanisms Responsible for Weight Gain with Sleep Deprivation Volume Matters Journal Watch Advertiser Index

Bariatric Times - June 2008

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